Abuse claims at 'seriously dysfunctional' care home

A patient was allegedly forced to kneel for hours in a garage with his nose against the wall at a ''seriously dysfunctional'' residence for the intellectually disabled.

The man also complained that he was kicked, beaten and videotaped by staff, who an inquiry later found were abusing and neglecting their highly-dependant clients.

Revelations of the widespread abuse, perpetrated at government-funded homes for the intellectually impaired across the upper North Island, follow an investigation that uncovered a litany of horrors at a residence in South Auckland, including a disabled boy who was left alone in a paddock to eat grass.

Reports of failings at that facility, Parklands, prompted Health Minister Tony Ryall to order a review of the auditing, monitoring and accreditation of all residential disability providers.

However, Ryall has so far refused to discuss the failings or the review. He will not answer questions directly about each case and refuses to comment on what kind of sanctions may be in order for either ministry staff or the owners and managers of each residence.

Latest Ministry of Health documents reveal that concerns from health professionals about the neglect of clinical care at facilities run by the Te Roopu Taurima O Manukau Trust, a nationwide provider, went unanswered for up to two years.

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At the same time, clients were physically assaulted by ''untrained and unsuitable'' staff - some who were former prisoners - who allegedly treated the residents more like inmates than patients.

Te Roopu Taurima caters to nearly 300 intellectually disabled clients, with 500 staff, across 54 residences located in Auckland, Northland, Waikato and Canterbury. Among its patients are those placed in compulsory care by the courts, many of whom have extremely high needs and present challenging behaviour.

The abuses of some of those clients were uncovered when two Auckland-based patients made allegations against staff members in early 2011. The ministry would not release the full complaints to Fairfax NZ but briefing notes released under the Official Information Act revealed one man complained he was kicked, hit and choked, had hot water thrown on him, was sworn at and made to sit in the corner as punishment.

Staff videotaped him while they ''restrained'' him, the man claimed. He also told his legal representatives he was made to kneel in a garage for long periods with his nose against the wall.

A letter in early 2011 from two doctors at the regional psychiatry service revealed other patients had bruising, had spoken of assaults, were not being given medication, and were being exposed to risky situations where they had access to drugs and alcohol. Previous attempts to raise these concerns had gone unanswered.

After the complaints came to light, the ministry audited four of the agency's residences, then inspected nine other homes to gain a ''clear understanding'' of the quality of the service.

Those audits co-incided with an investigation into Te Roopu Taurima O Manukau by the District Inspector for disability in Auckland. A ''Section 101'' inquiry - a top level investigation - was then ordered by the Director General of Health.

The inquiry found widespread breaches of the Intellectual Disability (Compulsory Care and Rehabilitation) Act 2003, as well as evidence of physical assaults and bullying.

District Inspector Colleen Newton wrote that while there was a genuine focus on kaupapa Maori, the service had a lack of supervision of staff leading to increased ''incidents'', a failure to implement clinical treatment programmes, failure to investigate complaints and a lack of transparency partly due to the employment of three family members in senior roles.

Details of whether the individual complaints were substantiated were not made clear, however, in a briefing to the Director-General of Health, a ministry official wrote that Newton's report ''contains sufficient evidence to conclude that there have been on-going and serious breaches of the rights of care recipients''.

Newton wrote that a failure to address basic abuses such as bullying and physical assaults had clearly ''permeated'' throughout the secure units, to the point where patients were now being processed through courts not only as perpetrators but as victims of abuse.

There had been a move away from core values towards a business model, resulting in a ''serious dysfunction'' within the organisation, she said.

Newton was concerned that various agencies with official oversight were clearly aware of the risk being imposed on patients but did not step in.

''Reports were tendered but it has, on the face of it, taken this inquiry to reveal the extent of the failure to address the situation,'' she said.

The inquiry - which has not been released publicly until now - advised immediate intervention.

The ministry responded by working with Te Roopu Taurima through last year, and finally, in February, putting in place an external monitor to ensure recommendations were met.

As a result of the internal investigation of alleged incidents of abuse or neglect, 10 staff were dismissed or have resigned, including the chief executive and senior staff members. Some of the cases were investigated by police and may come before the courts.

There was still no chief executive at the organisation but the service has kept its contract and the Ministry of Health says it will continue to work with Te Roopu Taurima.

''The ministry has been working closely with this service since 2011 to support them with their leadership and on developing and implementing their on-going quality improvement plan,'' a statement said.

Te Roopu Taurima's newly-appointed clinical manager, Sarah Williams, said the trust had made significant changes in relation to providing a higher than ever quality of care to its clients, which it calls mokopuna.

This included an anti-abuse campaign, implementing a zero-tolerance policy around reporting harm to patients, better staff supervision and training and better communication with other agencies.

''We are committed to mokopuna and their whanau to ensure that all those we care for are happy, that they're empowered with a lifestyle geared towards achieving independence and choice and that they are encouraged and supported in achieving their goals,'' Williams said.

Both men who complained of abuse in 2011 are now with different providers. The complaint from the man who said he had been forced to kneel in the garage did not go to court because the other patients were either unwilling, unable, or unsuitable witnesses, police said. Te Roopu Taurima will be part of the review ordered by the Minister of Health last week.